皖南医学院学报
皖南醫學院學報
환남의학원학보
ACTA ACADEMIAE MEDICINAE WANNAN
2014年
2期
157-158,161
,共3页
贲门腺癌%纵隔淋巴结转移%影响因素
賁門腺癌%縱隔淋巴結轉移%影響因素
분문선암%종격림파결전이%영향인소
gastric cardia adenocarcinoma%mediastinal lymph node metastasis%influential factors
目的：探讨贲门腺癌纵隔淋巴结转移相关因素，以明确纵隔淋巴结清扫指征。方法：回顾性分析2011年1月～2013年5月118例左胸入路手术治疗贲门腺癌患者临床资料，分析患者临床病理资料与纵隔淋巴结转移的关系。结果：全组病例共清扫纵隔淋巴结362枚，平均清扫每例淋巴结数（3．1±0．4）枚。纵隔淋巴结转移率为25．4％（30/118），转移度为11．6％（42/362）。肿瘤长度、浸润深度、分化程度、肿瘤是否累及食管下段与纵隔淋巴结转移有关，结果有统计学意义（P≤0．05）。结论：贲门腺癌其分化程度越低，肿块越大（最大直径超过3 cm），浸润越深，食管下端累及越容易发生纵隔淋巴结转移。临床工作中对这些患者应该常规行纵隔淋巴结清扫（主要是下纵隔淋巴结）。
目的：探討賁門腺癌縱隔淋巴結轉移相關因素，以明確縱隔淋巴結清掃指徵。方法：迴顧性分析2011年1月～2013年5月118例左胸入路手術治療賁門腺癌患者臨床資料，分析患者臨床病理資料與縱隔淋巴結轉移的關繫。結果：全組病例共清掃縱隔淋巴結362枚，平均清掃每例淋巴結數（3．1±0．4）枚。縱隔淋巴結轉移率為25．4％（30/118），轉移度為11．6％（42/362）。腫瘤長度、浸潤深度、分化程度、腫瘤是否纍及食管下段與縱隔淋巴結轉移有關，結果有統計學意義（P≤0．05）。結論：賁門腺癌其分化程度越低，腫塊越大（最大直徑超過3 cm），浸潤越深，食管下耑纍及越容易髮生縱隔淋巴結轉移。臨床工作中對這些患者應該常規行縱隔淋巴結清掃（主要是下縱隔淋巴結）。
목적：탐토분문선암종격림파결전이상관인소，이명학종격림파결청소지정。방법：회고성분석2011년1월～2013년5월118례좌흉입로수술치료분문선암환자림상자료，분석환자림상병리자료여종격림파결전이적관계。결과：전조병례공청소종격림파결362매，평균청소매례림파결수（3．1±0．4）매。종격림파결전이솔위25．4％（30/118），전이도위11．6％（42/362）。종류장도、침윤심도、분화정도、종류시부루급식관하단여종격림파결전이유관，결과유통계학의의（P≤0．05）。결론：분문선암기분화정도월저，종괴월대（최대직경초과3 cm），침윤월심，식관하단루급월용역발생종격림파결전이。림상공작중대저사환자응해상규행종격림파결청소（주요시하종격림파결）。
Objective:To investigate the related factors affecting the mediastinal lymph node metastasis in patients with gastric cardial adenocarcinoma for indications of necessary lymph node dissection .Methods:The clinical data were retrospectively analyzed in 118 cases of gastric cardial adenocarcinoma undergone surgical treatment in our department between Jan.2011 and May 2013.The outcomes of mediastinal lymph node metastasis were determined on the pathological finding basis of the patients.Results:Totally,362 pieces of mediastinal lymph nodes were dissected,mean(3.1 ±0.4)pieces,and the rate and ratio of mediastinal lymph node metastasis were 25.4%(30/118) and 11.6%(42/362),respectively.The metastasis to the mediastinal lymph nodes was associated with tumor size,pathological tumor depth,differentiation and presence or absence of involvement of the lower esophagus .The results were statistically significant (P≤0.05).Conclusion:Metastasis status of the mediastinal lymph nodes for cardial adenocarcinoma is associated with pathological factors,and occurs more common in cases with poorly differentiated and larger sized tumor ( >3 cm in diameter) ,deeper invasion and involvement of lower esophagus.Thus,conventional dissection of the mediastinal lymph nodes,especially the lymph nodes at the inferior mediastinum,is necessary for those types of patients.
